Provider Demographics
NPI:1922060474
Name:VALLEY NEUROLOGICAL ASSOCIATES P C
Entity Type:Organization
Organization Name:VALLEY NEUROLOGICAL ASSOCIATES P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-775-8801
Mailing Address - Street 1:3452 BRODHEAD RD
Mailing Address - Street 2:
Mailing Address - City:MONACA
Mailing Address - State:PA
Mailing Address - Zip Code:15061-3132
Mailing Address - Country:US
Mailing Address - Phone:724-775-8801
Mailing Address - Fax:724-775-0440
Practice Address - Street 1:3452 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:MONACA
Practice Address - State:PA
Practice Address - Zip Code:15061-3132
Practice Address - Country:US
Practice Address - Phone:724-775-8801
Practice Address - Fax:724-775-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA182931OtherBLUE SHIELD
OH9317721OtherMEDICARE GROUP NUMBER
PAVA448604OtherMEDICARE NUMBER
PA1507881Medicaid
CF6249OtherRAILROAD MEDICARE